EDUCATIONAL TOOL ONLY. Not legal or medical advice. Not affiliated with the VA.
← All Condition GuidesCLAIM RECON INTEL
Spinal Accessory Nerve Paralysis (CN XI)
✓ VERIFIED AGAINST 38 C.F.R.§ 4.124a (Neurological conditions and convulsive disorders) · reviewed 2026-05-15 · ClaimRecon Editorial Team
Spinal Accessory Nerve Paralysis (CN XI) is rated by the U.S. Department of Veterans Affairs under DC 8211 of 38 CFR § 4.124a, DC 8211 across 3 severity tiers (10% / 20% / 30%). Service connection requires (1) a current diagnosis, (2) an in-service event, injury, or exposure, and (3) a medical nexus opinion linking the two under 38 C.F.R. § 3.303.
OVERVIEW
Paralysis of cranial nerve XI causing weakness of the trapezius and sternocleidomastoid muscles.
RATING CRITERIA (3 LEVELS)
10%
Incomplete paralysis, moderate.
20%
Incomplete paralysis, severe.
KEY EVIDENCE TO GATHER
-Service treatment records showing injury or complaints
-Imaging (X-ray, MRI, CT)
-Range of motion measurements
-Flare-up documentation per Sharp v. Shulkin
-Buddy statements describing limitations
-Prescription history
-Physical therapy records
-Employment impact documentation
C&P EXAM TIPS (6)
1.Do NOT stretch, warm up, or take pain medication before your exam. The VA needs your baseline limitation.
2.Report your WORST day. DeLuca v. Brown requires documentation of functional loss during flare-ups.
3.Tell the examiner about flare-ups: frequency, duration, estimated ROM loss. Sharp v. Shulkin (2017) requires estimates.
4.Request active, passive, weight-bearing, and non-weight-bearing ROM testing per Correia v. McDonald (2016).
5.If you use assistive devices (brace, cane), bring them.
6.Describe daily activity impact: work, sleep, household tasks.
SOURCES & EDITORIAL
Rating criteria text quoted verbatim from 38 C.F.R. § 4.124a (Neurological conditions and convulsive disorders). Source verified 2026-05-15 by ClaimRecon Editorial Team during a regulation-text comparison against the Cornell Law CFR mirror; eCFR.gov is the authoritative government source.
EDUCATIONAL TOOL ONLY. NOT LEGAL OR MEDICAL ADVICE.
NOT AFFILIATED WITH THE U.S. DEPARTMENT OF VETERANS AFFAIRS.
CLAIM RECON 2026